January 8, 2010
NOONAN'S CONFUSION.... The Wall Street Journal's Peggy Noonan argues in her column today that President Obama could have had more success pursing a less ambitious health care reform bill.
In a way Mr. Obama made the same mistake President Bush did on immigration, producing a big, mammoth, comprehensive bill when the public mood was for small, discrete steps in what might reasonably seem the right direction.
The public in 2009 would have been happy to see a simple bill that mandated insurance companies offer coverage without respect to previous medical conditions. The administration could have had that -- and the victory of it -- last winter.
Instead, they were greedy for glory.
It's hard to overstate how incredibly wrong this is. The most obvious problem is that the president and his allies weren't "greedy" at all -- they gave up on single-payer before the process even started, and then compromised away several important elements in order to get it through Congress. The reform package -- like Social Security and Medicare before it -- is poised to be both a landmark achievement and a modest, moderate step forward.
But on a more fundamental level, Noonan's argument suggests she hasn't paid very close attention to the policy debate. As the former Reagan speechwriter puts it, all Obama should have done was prevent insurers from discriminating against those with pre-existing conditions. At that point, presumably, the president could declare victory and move on to the next subject.
Except, her proposal doesn't make sense. Paul Krugman explained today:
Start with the proposition that we don't want our fellow citizens denied coverage because of preexisting conditions -- which is a very popular position, so much so that even conservatives generally share it, or at least pretend to.
So why not just impose community rating -- no discrimination based on medical history? Well, the answer, backed up by lots of real-world experience, is that this leads to an adverse-selection death spiral: healthy people choose to go uninsured until they get sick, leading to a poor risk pool, leading to high premiums, leading even more healthy people dropping out.
So you have to back community rating up with an individual mandate: people must be required to purchase insurance even if they don't currently think they need it.
But what if they can't afford insurance? Well, you have to have subsidies that cover part of premiums for lower-income Americans.
In short, you end up with the health care bill that's about to get enacted. There's hardly anything arbitrary about the structure: once the decision was made to rely on private insurers rather than a single-payer system -- and look, single-payer wasn't going to happen -- it had to be more or less what we're getting. It wasn't about ideology, or greediness, it was about making the thing work.
I get the sense from Noonan's column that these pesky details don't matter. Like too many Republicans, making effective policy through sensible lawmaking just isn't that important.
Worse, Noonan went on to argue that the president put health care above the economy and national security -- which is as offensive as it is ridiculous. As Andrew Sullivan explained, "Noonan's column is a fantasy, a dream, a weird incantation of a thesis that is merely how she feels, without any substantive relationship to reality."
—Steve Benen 4:05 PM
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Andrew Sullivan wrote: "Noonan's column is a fantasy, a dream, a weird incantation of a thesis that is merely how she feels, without any substantive relationship to reality."
That describes ALL of Peggy Noonan's columns.
Posted by: KevinMc on January 8, 2010 at 4:08 PM | PERMALINK
"Noonan's column is a fantasy, a dream, a weird incantation of a thesis that is merely how she feels, without any substantive relationship to reality."
In other words, no different from anything any Publican, teabagger, or conservatroid mouthpiece has said for the last several years.
Posted by: smartalek on January 8, 2010 at 4:09 PM | PERMALINK
Peggy has a point. Look at the polls. First, Congress looted the treasury for the Democrat's supporters in govt unions.
Then Congress tried to shoot the moon on "health care"
Think of the idea of having confidence that if you governed successfully, you might keep your dominant political position. Instead, you guys acted like that football player who has never been in the end zone, and never expected to get there again.
Add to that, Cap and Trade, Immigration "Reform", you know the list.
There is a broad consensus for incremental health care reform, just not for this mess.
Posted by: tool of some sort on January 8, 2010 at 4:13 PM | PERMALINK
You guys seem to think that you are in some kind of ideological majority. You're not. You were in the "show me that you can" phase, and you panicked that you would never get 60 Senators again. Maybe it was a self fulfilling prophecy?
Posted by: tool of some sort on January 8, 2010 at 4:16 PM | PERMALINK
What the public "mood" was and what happened in Congress are almost completely unrelated.
The public wants health care reform. The Repubs/Blue Dogs don't. They were able the thwart the public "mood".
She truly does live in a fantasy land.
Posted by: martin on January 8, 2010 at 4:18 PM | PERMALINK
What's more disconcerting, that Noonan's an idiot treated by the media like she knows her sh!t, or that she does indeed know her sh!t, she knows her audience, and she can peddle this sh!t to them because it's what they want to hear, it's what they want to believe, they'll swallow it whole and ask for seconds?
Posted by: slappy magoo on January 8, 2010 at 4:19 PM | PERMALINK
Tool of some kind you make absolutely no sense. Then why would someone who goes by the handle of Tool of some sort make any sense. Just another jabbering idiot yelling on the street corner to no one in particular.
Posted by: Gandalf on January 8, 2010 at 4:40 PM | PERMALINK
Tool, did you even read the post? (Or are you just being sarcastic? If I have you in my irony blind spot, I apologize.) Why not make skyscrapers simpler by not larding them up with extras such as elevators and HVAC systems? And for that matter, aren't highway on-ramps and off-ramps just give-aways to union construction workers?
Posted by: walter on January 8, 2010 at 4:47 PM | PERMALINK
There is a broad consensus for incremental health care reform, just not for this mess.
Posted by: tool of some sort
Tool, you proved the point better then Noonan. Just jibber-jabber w/o any mention of actual specifics. What you think doesn't equal reality nor does it equal policy. No mention of republican obstructionism and filibustering every signal vote, no mention of the hold out D's taking large sums of cash from the Insurance/health Care Industries. Nothing, just you dribble about shooting for the moon and doing the endzone dance.
You would make a perfect guest on the Sunday morning shows. Bumper sticker blurbs.
Posted by: ScottW on January 8, 2010 at 4:48 PM | PERMALINK
I tried to post my reaction to Noonan's delusional column on the WSJ comment board and was blocked from doing so, Steve. No profanity, no personal attacks - I just pointed out that the column made no sense for all of the reasons you cite. Almost all of the comments were fawning praises of Noonan's writing brilliance. Sickening.
Conservatives reflexively censor opinions that don't match their own or that point out holes in their fractured and illogical worldview.
Posted by: Sam Simple on January 8, 2010 at 4:55 PM | PERMALINK
Peggie Noonan hasn't been right in the head since Reagan left office. She's the Miss Faversham of American politics, living in a misty dream world where Ronnie and the right are polite and virtuous and everyone else is rude and should quiet down and listen to Ronnie--or his ghost--speak gentle wisdom to them.
Posted by: Midland on January 8, 2010 at 4:57 PM | PERMALINK
...when the public mood was for small, discrete steps...
Depends on your definition of "public", I guess. Hers would consist mainly of fellow millionaire Republicans and media ho's...
Posted by: Doozer on January 8, 2010 at 5:13 PM | PERMALINK
Do her a favor, quit listening to her tripe! Ms. Noonan is irrelevant, befuddled, and must be on some sort of talking heads welfare - how can her too frequent appearances be otherwise explained? -Kevo
Posted by: kevo on January 8, 2010 at 5:55 PM | PERMALINK
The fact that they don't like to making effective policy is not important is why Medicare Part D was unfunded.
Posted by: MichMan on January 8, 2010 at 6:23 PM | PERMALINK
Peggy no thinky when too many drinky.
Posted by: penalcolony on January 8, 2010 at 7:05 PM | PERMALINK
Peggy is posting from the center of that “shining city on a hill” that made her famous. Unfortunately, she oversentmentalizes everything and her main goal is to canonize Reagan which would also solidify her status.. Mostly, her vision and understanding of the world is stuck in her voice of Reagan persona and her world is inhabited by other privileged white people. Certainly, Noonan and her contemporaries were the chosen during the Reagan era. Peggy’s fading breathlessness, both in person and on paper is mainly pathetic.
Posted by: DTR on January 8, 2010 at 7:33 PM | PERMALINK
Some people gain wisdom as they age. Other people become senile. Noonan is obviously in the latter category and shouldn't be blamed for anything she writes. But on the other hand, neither should she be taken seriously.
Posted by: Texas Aggie on January 8, 2010 at 11:37 PM | PERMALINK
Noonan's a twit, but so are the Dems.
Krugman sez: "Start with the proposition that we don't want our fellow citizens denied coverage because of preexisting conditions...."
Sure, everything follows logically from there but that's not the problem--the problem is what you "Start with".
No offense, but in the Great Recession I'm kinda busy trying to keep my family's collective heads above water. Our charitable donations have gone down as a result.
How about "Start with the proposition that healthcare should be non-profit"? That speaks to EVERYONE that uses healthcare.
Posted by: PoorRichard on January 8, 2010 at 11:55 PM | PERMALINK
I don't disagree with Steve very often, but I think he's totally wrong about this. If the Dems would have done what Noonan suggested - pass an initial bill this year that was more about insurance reform (i.e. making sure that people with pre-existing conditions could get coverage, forbidding people from being dropped from their coverage if they get sick, etc.) - and focus for the two years re-regulating Wall street/market and job creation, then the Dems maybe could have picked up two or three seats in the Senate and passed a more sweeping, progressive bill. Now, no one is very happy with the health bill, Obama's popularity is shrinking and the Dems could loose seats in the Senate. And, moreover, these were totally political/campaign finance calculatons: Obama really doesn't want to reregulate the market and thus basically did nothing on those garbage bills from the House and Senate; and he didn't want to do health care a few years before he had to run for re-election because he knew it would be divisive. Huge mistake on his part nevertheless.
Posted by: DS on January 9, 2010 at 8:29 AM | PERMALINK
Peggy Noonan is doing exactly what GOP hack Ron Christie and others of his species are doing on health care: make sure Republicans don't get blamed for their partisan obstruction by blaming Democrats for refusing to bargain in good faith.
Democrats could have had a health care reform bill anytime they wanted, say these Republicans. It just wouldn't have reformed a damned thing, and probably wouldn't have been about health care at all.
But Noonan et al can't let the public see it this way, so they pretend it was the extremism of the Democratic Party's Far Left base that kept an agreement from being sealed months ago. Republicans never cared about health reform, they only cared that their fingerprints were not found on the murder weapon that did in genuine reform.
Noonan's is the classical reactionary rheotorical ruse: Pretend to be the friend of popular reform. Just never let it ever happen.
Posted by: Ted Frier on January 9, 2010 at 10:27 AM | PERMALINK
And yet another reason not to watch This Week anymore -- the frequency with which THIS bubble head is called up to ponder the great issues of our day.
I want to see a Sacred Heart mud wrestling match between Peggy Noonan and Maureen Dowd, the breathy Irish redhead v. the acid-tongued one. The winner gets to continue being a no-brained pundit and the other just has to go away.
Posted by: Sarah Barracuda on January 9, 2010 at 1:59 PM | PERMALINK
"But Noonan et al can't let the public see it this way, so they pretend it was the extremism of the Democratic Party's Far Left base that kept an agreement from being sealed months ago."
Agreed. Also, Noonan's assertion that Obama could have easily gotten a bill through Congress which just prohibited discrimination based on pre-existing conditions is poppycock. The adverse-selection death spiral Krugman describes wouldn't just hurt ordinary Americans. It would also hurt insurance company profits. This means that it would have about the same chance of making it through Congress as the public option--less chance, actually, because with folks like Krugman saying that the economics was wrong, a bill like that couldn't even get the full support of the left.
Posted by: Kenneth Almquist on January 9, 2010 at 3:54 PM | PERMALINK